COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children: A Multinational Study.
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Antúnez-Montes Omar Yassef, Escamilla Maria Isabel, Figueroa-Uribe Augusto Flavio, Arteaga-Menchaca Erick, Lavariega-Saráchaga Manuel, Salcedo-Lozada Perla, Melchior Priscilla, de Oliveira Rodrigo Beréa, Tirado Caballero Juan Carlos, Redondo Hernando Pinzon, Montes Fontalvo Laura Vanessa, Hernandez Roger, Chavez Carolina, Campos Francisco, Uribe Fadia, Del Aguila Olguita, Rios Aida Jorge Alberto, Buitrago Andrea Parra, Betancur Londoño Lina Maria, Mendoza Vega León Felipe, Hernández Carolina Almeida, Sali Michela, Higuita Palacio Julian Esteban, Gomez-Vargas Jessica, Yock-Corrales Adriana, Buonsenso Danilo
Аннотация
METHODS: Ambispective multicenter cohort study from 5 Latin American countries. Children 18 years of age or younger with microbiologically confirmed SARS-CoV-2 infection or fulfilling MIS-C definition were included.
FINDINGS: Four hundred nine children were included, with a median age of 3.0 years (interquartile range 0.6-9.0). Of these, 95 (23.2%) were diagnosed with MIS-C. One hundred ninety-one (46.7%) children were admitted to hospital and 52 (12.7%) required admission to a pediatric intensive care unit. Ninety-two (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure and 29 (7%) on mechanical ventilation. Thirty-five (8.5%) patients required inotropic support. The following factors were associated with pediatric intensive care unit admission: preexisting medical condition (P < 0.0001), immunodeficiency (P = 0.01), lower respiratory tract infection (P < 0.0001), gastrointestinal symptoms (P = 0.006), radiologic changes suggestive of pneumonia and acute respiratory distress syndrome (P < 0.0001) and low socioeconomic conditions (P = 0.009).
CONCLUSIONS: This study shows a generally more severe form of COVID-19 and a high number of MIS-C in Latin American children, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hispanic children or in people of lower socioeconomic level. The findings highlight an urgent need for more data on COVID-19 in Latin America.